Does troponin or CK-MB last longer?
Troponin (7-10 days)
Why are nitrates useful in myocardial infarction?
Decrease preload = less demand on the heart
ACE inhibitors are useful in myocardial infarction?
Decrease Ang II
– Decrease vasoconstriction
– Decrease fluid retention
Contraction due to reperfusion can cause wavy bands due to influx of what?
Calcium
Microscopic changes 4 hours after MI
No changes
Order of damage of MI
- Coagulative necrosis
- Inflammation
* Neutrophils
* Macrophages - Granulation tissue via fibroblasts
- Fibrosis
1 day - Coagulative necrosis
1 week - Inflammation
1 month - Fibrosis
Within the first 4 hours of MI, what are the complications?
Heart failure, cardiogenic shock.
You don’t see any microscopic or gross changes
Within the first 24 hours of MI, what are the major complications?
Arrhythmia
Key complications of neutrophilic infiltration after MI? (1-3 days)
Pericarditis - friction rub
Only seen when there is a full wall necrosis
Key complications of macrophage infiltration after MI? (4-7 days)
Rupture
1. Ventricular free wall –> tamponade
2. Interventricular septum –> L–>R shunt
3. Papillary muscle –> mitral insufficiency (Right coronary artery)
Key complication during the granulation tissue phase of MI? (months after)
Aneurysm, Dressler Syndrome
Describe Dressler Syndrome
Antibodies against pericardium –> pericarditis
